According to the National Diabetes Statistics Report, diabetes remains one of the leading causes of death in the United States since 2010. Which of the following factors are risks for the development of diabetes mellitus? Select all that apply.
A. Age over 45 years
B. Overweight with a waist/hip ratio >1
C. Having a consistent HDL level above 40 mg/dl
D. Maintaining a sedentary lifestyle
E. Polycystic ovary syndrome
Correct Answer: A, B, D, & E.
Diabetes mellitus (DM) is a metabolic disease, involving inappropriately elevated blood glucose levels. The main subtypes of DM are Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM), which classically result from defective insulin secretion (T1DM) and/or action (T2DM).
Option A: Aging results in a reduced ability of beta cells to respond with insulin effectively. More than 25% of the U.S. population aged ?65 years has diabetes, and the aging of the overall population is a significant driver of the diabetes epidemic.
Option B: Overweight with waist/hip ratio increase is part of the metabolic syndrome of DM II. T2DM involves a more insidious onset where an imbalance between insulin levels and insulin sensitivity causes a functional deficit of insulin. Insulin resistance is multifactorial but commonly develops from obesity and aging.
Option C: The NCEP ATP III guidelines indicate that the ideal HDL levels should be between 40 and 60 mg/dL. The primary function of HDL is the transport of cholesterol from the peripheral tissues to the liver, playing a role in the biodistribution of lipids. HDL is known for its anti-atherogenic and anti-inflammatory properties, thanks to its uptake and return of the cholesterol stored in the foam cells of atherosclerotic plaques to the liver.
Option D: There is an increase in atherosclerosis with DM due to metabolic syndrome and a sedentary lifestyle. Relatively high amounts of sedentary time (daily/weekly sitting time) have been associated with significantly greater risk for type 2 diabetes and metabolic syndrome in two meta-analyses.
Option E: For women, having polycystic ovary syndrome — a common condition characterized by irregular menstrual periods, excess hair growth, and obesity — increases the risk of diabetes.
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